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Fate of Surgical Patients with Small Nonfunctioning Pancreatic Neuroendocrine Tumors: An International Study Using Multi-Institutional Registries

Authors
 In Woong Han  ;  Jangho Park  ;  Eun Young Park  ;  So Jeong Yoon  ;  Gang Jin  ;  Dae Wook Hwang  ;  Kuirong Jiang  ;  Wooil Kwon  ;  Xuefeng Xu  ;  Jin Seok Heo  ;  De-Liang Fu  ;  Woo Jung Lee  ;  Xueli Bai  ;  Yoo-Seok Yoon  ;  Yin-Mo Yang  ;  Keun Soo Ahn  ;  Chunhui Yuan  ;  Hyeon Kook Lee  ;  Bei Sun  ;  Eun Kyu Park  ;  Seung Eun Lee  ;  Sunghwa Kang  ;  Wenhui Lou  ;  Sang-Jae Park 
Citation
 CANCERS, Vol.14(4) : 1038, 2022-02 
Journal Title
CANCERS
Issue Date
2022-02
Keywords
nonfunctioning neuroendocrine tumor of pancreas ; prognosis ; resection ; risk factors
Abstract
Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors ≤ 2 cm do not necessarily need surgery. This study aims to establish a surgical treatment plan for NF-pNETs ≤ 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs ≤ 2 cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. The median age was 56 (range 16-80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (>1.5 cm; HR 4.28, 95% CI 1.80-10.18, p = 0.001) and nodal metastasis (HR 3.32, 95% CI 1.29-8.50, p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (HR 4.36, 95% CI 1.48-12.87, p = 0.008) and high Ki-67 index (≥3%; HR 9.06, 95% CI 3.01-27.30, p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs ≤ 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5 cm, Ki-67 index ≥ 3%, or nodal metastasis was present. NF-pNET patients with tumors ≤ 1.5 cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decisions about small NF-pNETs.
Files in This Item:
T9992022712.pdf Download
DOI
10.3390/cancers14041038
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193483
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